Merritt Hawkins Survey

FPs at Top of Recruitment List for Seventh Straight Year

For the seventh straight year, the demand for family physicians outpaced the demand for other specialists, according to the annual Merritt Hawkins survey(www.merritthawkins.com), which was based on more than 3,000 recruiting assignments conducted by the health care search and consulting firm between April 1, 2012, and March 31.

The survey looked at medical specialties based on candidate population size and found that family medicine still is the "most requested and difficult search out there in terms of the sheer number of requests," said Travis Singleton, senior vice president for Merritt Hawkins.

FPs likely would be the most requested search based on the sheer volume of physicians in the specialty, said Singleton, but he added, "Family physicians are our No. 1 search request because of the demand, not just because of how big the specialty is."

Family medicine and internal medicine ranked first and second, respectively, in the survey in terms of most-requested searches. The top five recruitment areas in the survey are

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Family physicians topped the list of the most highly recruited physicians for the seventh straight year in a 2012-13 Merritt Hawkins survey.

The survey findings affirm the dominance of family medicine in the nation's evolving health care system.

Much of the growing demand for family physicians overall stems from a growing demand for employed FPs, in particular.

family physicians, 624 searches;

internal medicine physicians, 194 searches;

hospitalists, 178 searches;

psychiatrists, 168 searches; and

emergency medicine physicians, 111 searches.

"The new mantra in health care is to be 'everywhere, all the time,'" said Mark Smith, president of Merritt Hawkins in a recent press release(merritthawkins.com). "This means reaching into communities with a growing number of free-standing facilities or other sites that are convenient and accessible. These facilities have one thing in common -- they all need primary care physicians."

Ongoing Demand

According to Merritt Hawkins, other factors also are driving the demand for family physicians. During the past decade, hospitals and health care systems have spent hundreds of millions of dollars building neuroscience labs, orthopedic centers, and heart and cancer centers. Increasingly, there is a realization among these hospitals and health centers that they need a primary care referral network to meet the needs of patients accessing the facilities, said Singleton.

Despite the demand for family medicine, however, the average salary offered to FPs in the Merritt Hawkins search assignments dropped slightly from $189,000 in 2012 to $185,000 in 2013. But, according to the survey, this decline "does not represent an easing of demand for family physician as much as a shift in the types of positions they are being recruited to fill."

"A growing number of Merritt Hawkins' family medicine search assignments are for outpatient-only settings where call is not required," said the survey. These settings may encompass "urgent care and emergency department settings or office-base settings where call is handled by hospitalists."

"Because these settings often are viewed as more desirable by physicians, income offers may not be as high as in less desirable settings. In addition, demand for family physicians in traditionally desirable geographic locations, such as metropolitan, ocean-front or mountain settings, is increasing, and facilities in these settings may not need to be as competitive as facilities in less desirable locations."

The survey also noted that "salary offers for family physicians grew from $173,000 in 2009 to $185,000 in 2013, an increase of 7 percent. At some point, salary offers for family physicians and other primary care physicians may reach a plateau that can only be raised by a change in reimbursement policy."

Salaried Positions

Like past surveys, this year's survey documents the growing number of physicians who are opting for salaried positions. In 2004, 11 percent of Merritt Hawkins search assignments were for employed physicians; today, that number stands at 64 percent, a trend that has profound implications for patient care.

According to Singleton, employed physicians, as a rule, may not be as financially or emotionally invested in a given practice as a physician owner. This makes it more likely that employed physicians will switch practices, leading to higher physician turnover rates.

"There is nothing tying these physicians to that practice or that hospital or system, meaning they can change flags at the drop of a hat," said Singleton.

"If the turnover is higher and the productivity is lower, it means we are going to need more physicians and to be more fluid in how we staff," said Singleton.

The survey also looked at overall compensation packages for physicians and found that nearly 40 percent of Merritt Hawkins' searches contained some type of quality-of-care component as part of the compensation. Nevertheless, these quality metrics affected less than 5 percent of individual physician compensation structures, hardly enough to change physician behaviors, according to Singleton.

Most compensation packages still are based primarily on production and relative value units, making quality metrics "aspirational" at this point, he said.